This d’Amico prostate cancer risk calculator evaluates prostate neoplasm recurrence after or before localized treatment based on PSA, Gleason score and cancer stage. You can read more about the criteria used in this risk assessment model and the three possible results below the form.
How does this d’Amico prostate cancer risk calculator work?
This is a health tool that evaluates the recurrence risk following the localized treatment of prostate cancer and can also be used in making informed further treatment decisions.
There are three groups: low, intermediate and high risk and three indicators that are being assessed. This d’Amico prostate cancer risk calculator uses a combination of the blood PSA levels, the Gleason grade and the T score of tumor stage as the original risk assessment model.
1. PSA in ng/mL – value measured at diagnosis and is below 10; between 10 and 20 or above 20. This is the prostate specific antigen, a protein of the prostate cells that can be found in blood. Raised PSA is a sign of prostate cancer but this is not used as sole diagnosis as there are many cases exhibiting raised PSA levels without cancer diagnosis and also cases of prostate cancer with normal PSA.
2. Gleason score – this is the score of the biopsy (primary or secondary) and has as choices: less or equal to 6, 7, 8 or higher than 8. The Gleason grading system is used by pathologists in the biopsy examination and is based on the architectural pattern on the glands and the degree of resemblance to normal cells.
3. Clinical stage – this refers to the T stage, either T1 or T2a, T2b or T2c,T3a. Clinical stages use the TNM T part as an indicator of how large and spread the prostate neoplasm is.
- T1 tumors are small and can only observable just through biopsy.
- T2 tumors are divided in T2a, T2b and T2c depending on the localization inside the gland and the spread.
- T3 tumors go through the glandular capsule (T3a).
Interpreting the result
Low risk – is representative for PSA less than or equal to 10, a Gleason score less than or equal to 6 and a clinical stage T1-2a. This suggests that the prostate cancer is growing at a slow rate and is unlikely to spread to other tissues in the following years. As a precaution, there could be used active surveillance with frequent ultrasounds, imagistic or biopsies.
Intermediate risk – is representative for PSA between 10 and 20, a Gleason score of 7 and clinical stage T2b. However, cases in which the clinical stage is T1-2a but the PSA is between 10 and 20, regardless of Gleason being lower than 7 or 7 are still considered intermediate risk. This suggests that the prostate neoplasm is growing at a moderate rate and is unlikely to spread in a few years time. In some cases, there still might be need for medication, radiation or surgery to mitigate risks further.
High risk – is representative for PSA more than 20, a Gleason score equal or larger than 8 or clinical stage T2c, T3a. Similar to intermediate, if any of the three above are present, regardless of the other two, there is still considered a high risk cancer. This is suggestive for a changed architecture of the glandular tissues with poorly differentiated cells that are loosing their normal function and the neoplasm is likely to spread further from this stage in the following years.
Another useful cancer risk assessment
Is the UCSF-CAPRA score based on the model developed by Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE). This is a formula that aims to help specialist decision making and is improved beyond the d’Amico model as to address some of its limitations. Go to the Prostate Cancer Risk Calculator!
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2) Matthew R. Cooperberg, MD, MPH, David J. Pasta, MS, Eric P. Elkin, MPH, Mark S. Litwin, MD, MPH, David M. Latini, PhD, Janeen DuChane, PhD, and Peter R. Carroll, MD† The UCSF Cancer of the Prostate Risk Assessment (CAPRA) Score: a straightforward and reliable preoperative predictor of disease recurrence after radical prostatectomy. J Urol. 2005 Jun; 173(6): 1938–1942.
3) Hernandez DJ, Nielsen ME, Han M. Contemporary evaluation of the D'amico risk classification of prostate cancer. Urology. 2007 Nov;70(5):931-521 Jun, 2015